Healthcare Provider Details

I. General information

NPI: 1437086543
Provider Name (Legal Business Name): OPTIMCARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13821 WOODWARD AVE STE B
HIGHLAND PARK MI
48203-3624
US

IV. Provider business mailing address

13821 WOODWARD AVE STE B
HIGHLAND PARK MI
48203-3624
US

V. Phone/Fax

Practice location:
  • Phone: 313-478-4530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: N BAYDOUN
Title or Position: MEMBER
Credential:
Phone: 313-478-4530